Overview of CRC (2/3)
CRC Screening
CRC is one of the few cancers for which there is an effective method of detecting abnormalities, such as polyps, before cancer ever occurs. Fecal occult blood screening and colonoscopy are recommended methods of colon cancer screening. The American Cancer Society (ACS) recommends that all asymptomatic adults begin colon cancer screening at age 50.1,9 Today, slightly more than 50% of adults older than 50 have been screened. The goal of the ACS is to screen 75% of these individuals by 2015.7
Recommended CRC Screening Procedures
| Test/Procedure | Frequency |
| Fecal occult blood test (FOBT) or Fecal immunochemical test (FIT) | Annually |
| Flexible sigmoidoscopy (FSIG) (detects cancers in the rectum and sigmoid) | Every 5 years |
| FOBT or FIT plus FSIG: preferred to either alone* | Annual FOBT or FIT, and FSIG every 5 years |
| Double-contrast barium enema (DCBE) | Every 5 years |
| Colonoscopy (detects cancer in the cecum and ascending, transverse, and descending colon) | Every 10 years or follow-up if other screening tests are abnormal |
*Individuals at moderate or high risk for CRC should talk with a doctor about a testing schedule. Data from the American Cancer Society. Cancer Facts & Figures 2007.1
Figure 1. Colorectal system
CRC Myths
There are myths concerning CRC:
| Myth: | Colon cancer occurs more often among men than women |
| Fact: | Colon cancer affects men and women equally |
| Myth: | Flexible sigmoidoscopy is equivalent to colonscopy |
| Fact: | Flexible sigmoidoscopy visualizes only the lower portion of the colon; colon cancer can occur anywhere along the length of the colon (Figure 1) |
| Myth: | Colonoscopy procedure is painful |
| Fact: | Conscious sedation is used, very little discomfort is experienced |
| Myth: | Preparation for colonoscopy is extensive and difficult to complete |
| Fact: | Different preparations are available including a “half-volume solution” and laxative pills. Discuss options with the ordering physician or endoscopist about which preparation is best for you10 |
A patient education sheet by Zeller et al (JAMA. 2006;296:1552) which discusses colorectal cancer screening and diagnosis, can be viewed and printed here.
http://jama.ama-assn.org/cgi/reprint/296/12/1552
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